Perianal streptococcal dermatitis: Difference between revisions
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==Background== | ==Background== | ||
*Skin infection caused by group A beta-hemolytic strep | {{Skin anatomy background images}} | ||
*Skin infection caused by [[group A beta-hemolytic strep]] | |||
*See in ages 6 mos - 10 yrs | *See in ages 6 mos - 10 yrs | ||
{{Dermatitis types}} | |||
==Clinical Features== | ==Clinical Features== | ||
[[File:PMC4968311 gr1.png|thumb|Well-demarcated salmon-pink to erythematous plaque with overlying scale and pustules on the right side of the groin.]] | |||
[[File:Perianal streptococcal dermatitis.png|thumb]] | [[File:Perianal streptococcal dermatitis.png|thumb]] | ||
On physical exam<ref>Brilliant LC. Perianal streptococcal dermatitis. Am Fam Physician. 2000; 61(2):391-393.</ref>: | On physical exam<ref>Brilliant LC. Perianal streptococcal dermatitis. Am Fam Physician. 2000; 61(2):391-393.</ref>: | ||
*Bright red, sharply demarcated, perianal rash | *Bright red, sharply demarcated, perianal [[rash]] | ||
*Spead to the vulva or penis | *Spead to the vulva or penis | ||
*Subcutaneous involvement suggestive of cellulitis is normally absent | *Subcutaneous involvement suggestive of cellulitis is normally absent | ||
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{{Neonatal rashes DDX}} | {{Neonatal rashes DDX}} | ||
== | ==Evaluation== | ||
*Rapid strep test | *Rapid strep test | ||
==Management== | ==Management== | ||
*[[Amoxicillin]]<ref>Barzilai A and Choen HA. Isolation of group A streptococci from children with perianal cellulitis and from their siblings. Pediatr Infect Dis J. 1998; 17:358–360.</ref> | *[[Amoxicillin]]<ref>Barzilai A and Choen HA. Isolation of group A streptococci from children with perianal cellulitis and from their siblings. Pediatr Infect Dis J. 1998; 17:358–360.</ref> | ||
** | **40mg/kg divided TID x 10 days | ||
'''AND''' | '''AND''' | ||
*[[Mupirocin]] | *[[Mupirocin]] | ||
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==Disposition== | ==Disposition== | ||
*Discharge home | *Discharge home | ||
*Close | *Close follow up recommended as recurrence can occur in up to 39% of cases<ref>Kokx NP, Comstock JA, and Facklam RR. Streptococcal perianal disease in children. Pediatrics. 1987; 80:659–663.</ref> | ||
==See Also== | ==See Also== | ||
*[[Streptococcal pharyngitis]] | *[[Streptococcal pharyngitis]] | ||
*[[Strep. Groups A, B, C, G]] | *[[Strep. Groups A, B, C, G]] | ||
*[[Neonatal rashes]] | |||
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pediatrics]] | |||
[[Category:Dermatology]] | |||
[[Category:ID]] | |||
Latest revision as of 17:27, 11 December 2024
Background
- Skin infection caused by group A beta-hemolytic strep
- See in ages 6 mos - 10 yrs
Dermatitis Types
- Atopic dermatitis
- Candida dermatitis
- Cercarial dermatitis
- Contact dermatitis
- Dermatitis herpetiformis
- Diaper dermatitis
- Dyshidrotic dermatitis
- Neonatal seborrhoeic dermatitis
- Nummular dermatitis
- Perianal streptococcal dermatitis
- Perioral dermatitis
- Seborrheic dermatitis
- Stasis dermatitis
Clinical Features
On physical exam[1]:
- Bright red, sharply demarcated, perianal rash
- Spead to the vulva or penis
- Subcutaneous involvement suggestive of cellulitis is normally absent
- Absence of systemic signs of infection
Differential Diagnosis
Neonatal Rashes
- Acne
- Atopic dermatitis
- Candidiasis
- Contact dermatitis
- Diaper dermatitis
- Erythema toxicum neonatorum
- Impetigo
- Mastitis
- Milia
- Miliaria
- Mongolian spots
- Omphalitis
- Perianal streptococcal dermatitis
- Psoriasis
- Pustular melanosis
- Seborrheic dermatitis
- Sucking blisters
- Tinea capitis
Evaluation
- Rapid strep test
Management
- Amoxicillin[2]
- 40mg/kg divided TID x 10 days
AND
- Mupirocin
- 2% TID x 10 days
Disposition
- Discharge home
- Close follow up recommended as recurrence can occur in up to 39% of cases[3]
See Also
External Links
References
- ↑ Brilliant LC. Perianal streptococcal dermatitis. Am Fam Physician. 2000; 61(2):391-393.
- ↑ Barzilai A and Choen HA. Isolation of group A streptococci from children with perianal cellulitis and from their siblings. Pediatr Infect Dis J. 1998; 17:358–360.
- ↑ Kokx NP, Comstock JA, and Facklam RR. Streptococcal perianal disease in children. Pediatrics. 1987; 80:659–663.